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Biomedical subjects

J Kletenský

Publications and source records attributed to J Kletenský.

At least 19 recordsLinked to original sources
PubMed2006

Defect of the sternal area.

Defects of the sternum are a result of severe postoperative complications in certain cardiosurgery patients. The use of pedicle muscle flaps for closure of these defects is currently already a standard and reliable method. The most commonly used muscles for covering the sternal area and filling the frontal mediastinum are the pectoralis major and rectus abdominis muscles. There are several ways to use these muscles for the individual concrete situations. Based on the experience they have gained over the past six years with 84 patients, the authors describe technical aspects of the individual variations as well as the relevant advantages and disadvantages.

Cardiac Surgical Procedures↗
PubMed2005

Bronchial myoplasty with the use of latissimus dorsi muscle--a case study.

Dehiscence of the bronchial stump as well as the tracheo-bronchial-pleural fistula is a rare but life-threatening complication of pulmonary resections. Absence of the immediately accessible well vascularized soft tissues makes successful direct resuture of the bronchial stump or local closure of the defect problematic, particularly in the infected terrain. The authors describe a case study of successful closure of the tracheo-bronchial defect with the use of pediculated latissimus dorsi muscle in a cachectic 63-year-old patient after a right-side pneumonectomy.

Bronchial Fistula↗
PubMed2001

Breast reconstruction using free tram flap transfer--ten years experience.

Over the course of ten years, 119 breast reconstruction procedures using a free TRAM flap transfer were performed in our department. In the present review, the authors explain the indication pattern for breast reconstruction. The age of patients undergoing breast reconstruction is given, as well as a description of the time interval between mastectomy and breast reconstruction, which recipient vessels were used, the general and local complications and the complications relating to the anastomosis. The review of the group of patients is supplemented by information on the time interval between breast reconstruction and reconstruction of the nipple areolar complex as well as summarized data on the results of breast reconstruction that were achieved using a free TRAM flap transfer.

Adult↗
PubMed2001

Aplasia of the breast--reconstruction using a free tram flap.

Breast aplasia and hypoplasia are found most frequently in Poland's syndrome but may also be the consequence of damage to the germ of the mammary gland in childhood. The authors present two cases of breast aplasia in which reconstruction was implemented by free transfer of a TRAM flap. The internal mammary vessels were used as recipient vessels, the condition of which was tested before surgery by Doppler. In both instances the reconstruction was implemented at the age of 19 years, and subsequently the areolomammillary complex was created and the contralateral breast corrected to achieve symmetry. The use of autologous tissue in the form of a free TRAM flap provides, in this indication, very good results that are permanent, and the problems associated with the use of implants are eliminated.

Adult↗
PubMed2000

Evaluation of results of replantations at the Department of Plastic Surgery, University Hospital Královské Vinohrady, during the period 1994-1999.

During the period from 1994-1999, 226 patients were treated, incl. 91 replantations and 135 revascularizations. The group included 199 men and 27 women. The success rate of microsurgical reconstruction operations in replantations was 78%, in revascularizations 93%. As compared with the period 1984-1993, the success rate in replantations improved by 4%, while the indication pattern was preserved.

Accidents, Occupational↗
PubMed2000

Capsular contracture in augmentation mammaplasty.

In a group of 331 augmentation mammaplasties performed at the Clinic of Plastic Surgery in Prague from 1994-1998, capsular contracture was recorded in 6% cosmetic and 12% of reconstruction operations. The main cause was, in particular, the quality of tissue surrounding the implants along with individual disposition. The incidence of this complication did not differ significantly in relation to the placement of the prosthesis beneath the muscle or gland. Based on histological analysis and the clinical finding, it is obvious that disintegration of the prosthesis does not always lead to severe grades of capsular contracture. It is despite the presence of foreign bodies in the connective tissue.

Adult↗
PubMed1999

Treatment of chronic osteomyelitis of the lower extremity using free flap transfer.

Between 1987 and 1995, 25 patients with chronic osteomyelitis of the lower extremity were treated by transfer of muscle or musculocutaneous flap. The subsequent follow-up extended over more than three years. Five patients developed a recurrence. Two were reoperated on and healed completely; in two an amputation had to be performed; and in one the infection persists. Recurrence occurred mainly in patients in whom the bone cavity could not be filled completely with muscle.

Adolescent↗
PubMed1996

Chronic traumatic wounds of the leg.

The authors report the results of a retrospective study of the treatment of chronic defects of soft tissues and bones of the leg and foot with free muscle and musclecutaneous flaps. The study deals with the results of the use of the microsurgical techniques during the period of 11 years at the Department of Plastic Surgery of the 3rd Medical School in Prague. Discussed are the advantages and disadvantages of this technique as one the of possible therapeutic methods inclusive of the results obtained at the above mentioned department.

Anastomosis, Surgical↗
PubMed1996

Treatment of defects and instable skin scars on heavily exposed parts of the leg.

The authors report a series of 41 patients subjected to a transfer of the sensitive fasciocutaneous flap to a defect or to instable skin scars on the leg. Described are immediate as well as longterm surgical results in relation to the sensitivity of the transferred flap and the condition of the donnor site of the flap.

Anastomosis, Surgical↗
PubMed1995

Free cross leg flap as a method of reconstruction of soft tissues defects.

Authors demonstrate on clinical cases the possibility of reconstruction of soft leg tissues by the use of the so called free cross flap. This method appears to be convenient in cases where there are no suitable recipient vessels within reach on the injured extremity and where the defect is of such an extent that the conventional cross flap does not provide sufficient amount of tissue.

Adolescent↗
PubMed1995

Internal mammary vessels as recipient vessels to the free TRAM flap.

For the reconstruction of the breast after mastectomy, it is possible to use the internal mammary artery and vein as recipient vessels. The authors consider their experience and some new knowledge gained on the basis of 53 cases. They try to promote the indisputable advantages of the use of the mentioned recipient vessels.

Female↗
PubMed1994

Importance of an early tissue transfer in the treatment of complicated injuries of lower extremities.

3rd degree fractures with extensive defects of soft tissues represent a major therapeutical problem. The technique of free tissue transfer makes it possible to adopt an active access to primary treatment to this injuries. Radical necrectomies may be performed without respect to the extent of the defect that will arise. The authors present their experience regarding an early coverage of the defect of the lower extremity by means of a free flap. The time period between the accident and tissue transfer as well as a suitable flap type are taken in consideration.

Accidents, Traffic↗
PubMed1994

Ten years of replantation surgery at the Department of Plastic Surgery, Charles University Hospital, Prague.

The authors present results of the ten years replantation surgery centre at the department of plastic surgery in Prague. The presented series of patients includes 393 persons operated on because of amputation or ischaemic injury to the region of the upper extremity. The number of replantations and revascularisations in the individual years is analysed, as well as the age of the patients, type of injury, mechanism of injury and operation results.

Adolescent↗
PubMed1994

Use of free flaps in burn trauma.

The present currently used method of treating and reconstructing injuries caused by electric current and deep thermal injuries is compared with the method of early reconstruction using free flaps. Brief summary of present experience substantiating this method is presented. The three presented clinical cases show subacute reconstruction in this type of injury by free flaps transfer.

Adolescent↗
PubMed1993

Sequelae of an injury from the Second World War treated by free flap transfer.

The authors present the case-history of patients with chronic osteomyelitis of the proximal third of the tibia-resulting from an injury during the Second World War. The defect of bone and soft tissues was treated by free transfer of a musculocutaneous flap. The behaviour of the flap in the osteomyelitic cavity is followed up and checked by repeated CT and NMR examinations.

Chronic Disease↗
PubMed1992

An extensive defect on the tibia covered by a free cross flap using m. latissimus dorsi.

Using a clinical case, the authors demonstrate the technique of covering an extensive tibial defect unmanageable, due to blood supply to the limb and extent of the defect, by conventional methods. The required amount of tissue was provided by a flap obtained from m. latissimus dorst transferred to the site of defect as a free cross flap.

Abdominal Muscles↗
PubMed1990

Thumb reconstruction using free flap transfer.

The authors present a choice of thumb reconstruction method using free transfer of sensitive radial artery flap together with autologous bone graft implantation in a single-time operation. They regard this approach as more advantageous than the standard tubed flap techniques. The advantages are the following: 1. single-time operation, 2. flap tissue sensitivity, and 3. satisfactory shape of the reconstructed thumb, requiring no subsequent modellation. Photographs show the surgical procedure and three other casuistics.

Adolescent↗